Ah It’s June 2nd.

I guess it’s been a while since my last update. 

I’ll back track a little and get you up to speed.

In the middle of a February snow storm I went back to Swedish to re-excise a small area of tissue that still contained cancer cells. This was a successful surgery as in Dr Han got clear margins, she also removed such a large area of tissue that it shocked me a bit when I felt this huge indentation on my chest. 

At my follow up appointment she confirmed that they got clear margins, they were really close but they were clear. This is not something I worried about afterwards.

By this time more pathology results from my mastectomy was available, it confirmed that there was a small focal area of invasive cancer cells. It was a bit daunting to think about the what ifs mainly the what if my breast hadn’t started bleeding when it did.

Dr Han started pushing hormone therapy after biopsy showed that huge 14cm tumor but now she was insisting on it and also referring me to a radiation oncologist at Swedish.

I also saw Dr Wei who gave the ok for me to have my expanders placed. I went on to have that surgery on February 22nd. It was a bit more painful than I had expected but I believe that I bounced back pretty quickly. 

During my re-excision on February 11th, extra skin has been excised because of an infection. The extra trauma of multiple surgeries and having more skin removed would pose a bit of problems for my reconstruction. The scar tissue build up was preventing my skin from stretching forward. Dr Wei placed the expanders without filling it at all because of how tight the space was. The filling process continued to be slow and to today it’s improved but I still have a huge lump. 

In the meantime I had a follow up appointment with Dr Semien, she pretty much came into the office and said yay you’re cured and don’t need chemo. The not needing chemo part was great but her casual everything should be fine now was a little weird to me. 

I continued to have weekly appointments with Dr Wei and then met with Dr Astrid on March 13th at Swedish. Remember the part about clear margins that were really close and I wasn’t worried about it? Well this came up, what I hadn’t realized was that the close margins 1mm was on the side closest to my armpit area. In other words, there were cancer cells right up in that corner only 1mm away from healthy tissue. Like I said, I wasn’t so worried about this before but now I was. She presented a really strong case for radiation therapy and was recommending 6 ½ weeks of radiation. Her case was focused on my age and the percentage of reoccurrence with and without radiation. She was also quite focused on the sheer size of my mondo tumor, and its grade 3 with comedo necrosis. She wasn’t too concerned about the invasive component because it was very small. If I were to go through with radiation it would be everyday Monday-Friday so there’s no way I could do it in Seattle. I asked for a referral to meet someone in Olympia. 

I left Dr Astrid’s office a bit confused about a few things so I made an appointment to see Dr Han again. I basically was left with a lot of questions about the close 1mm margins and what that meant and where it was etc. She had a photo of the piece of tissue she removed on Feb 11th, kinda gross but hey whatevs. She said that she removed a significantly large piece of tissue something like 9x10x3, no wonder I have a huge indent. As she talked more about where the cancer cells were etc I just knew in my gut if they had continued past that 1mm margin that they probably would have found more cancer cells. After all I seem to have had the cancer that keeps on giving. Before leaving her office she explained that a medical oncologist is the person that would follow me every six months. Seeing as I didn’t quite click with Dr Semien, I asked for a referral to see someone at Swedish. 

I met with Dr Yan a couple of weeks later and while she also confirmed that I wouldn’t need chemo I liked her a lot more and so I’ll be checking in with her every six months for a while. 

I continued to see Dr Wei and had begun some massage therapy for my left breast which is helping, albeit a bit slow. I also met with Dr Sorum at Capital Medical Center in Olympia and he will be my radiation oncologist. 

Oh yeah did I mention that I agreed to go through with radiation? They say it’s up to me if I want to or not, but they were all very convincing so leaving it to chance seemed a bit silly. He is recommending 5 ½ weeks of treatment. I pretty much decided to go along with the radiation and not the hormone therapy because it is more targeted and would be the most effective. 

It’s National Cancer Survival Day and I’ve been seeing questions all day about what it means to you to be a survivor. To be honest, I am still trying to figure that out. I ended up telling Luna’s ballet teacher about having to start radiation and she asked if everything was ok. I told her about my diagnosis last summer and her reply was “I had no idea, you always seem so happy and positive.” I replied with “what else am I going to do” I guess for me her response is what I would think being a survivor meant. I do have my down days, or down moments but for the most part I’m just me trying to do me. 

Last week I had a few down days, then a really bad day so maybe the whole damn week was a wash. I went in to have scans done for sequencing my radiation therapy on May 21st, it was also 4 months to the date of my double mastectomy. That weighed a bit heavy on me especially in a really quiet room going in and out of the scanner. Laying there thinking, what the hell has happened. Where did all of this come from?  June 20thwould make it a full year of breast cancer related bullshit. I had spent six months having tests, scans and probes with referrals and opinions, second opinions and even third opinions. When January came along I was scared, nervous and all the emotions in between that come with a cancer diagnosis and the reality of having to lose my breasts. For a little while it was all about breasts not being the definition of who I am as a person or a woman, but man three surgeries later your self esteem really takes a hit. A double mastectomy they say will take care of that pesky cancer. Try a double mastectomy with a woah that was a big ass tumor and guess what we didn’t get all of that sucker the first time around. Expanders? That’s easy peasycompared to the other two, but wait look out for all that scar tissue that is a result of traumatized skin following two now three surgeries. I now have an uneven deformed chest, they’re not even foobs yet.  Double Mastectomy and we’re done right? Ha! Now not only do I have a deformed chest, but radiation treatment has snuck its way into my treatment plan. I get to have my deformed not yet foobs for a whole year. That’s how long it takes for my skin to fully heal from radiation. My massage therapist has assured me that I am doing remarkably well and have great range of motion but we will definitely be taking a few steps backwards with radiation.  

The Friday before the Memorial Day weekend I woke up and  my right boob was flat and squishy and weird. I sent pictures to my plastic surgeon and she says it looks like my expander has flipped and not ruptured. On a side note, I’ve taken so many boob photos and so many people have seen me without a shirt pre and post boobs that it doesn’t even phase me anymore. Anyway that was the tipping point of my down week. I started driving Luna to school and everything came crashing down, I sobbed all the way to school. Then my mom called which was a bit witchy, she asked what was wrong and the truth of it was that it was everything and it was also nothing. That may sound confusing but it wasn’t just realizing that something was up with my right boob because these haven’t felt like my boobs at all, I don’t even really go out of my way to hide my bump. I guess I needed a good cry. 

I made an appointment to see Dr Wei last Thursday, I was so curious about how she was going to flip my expander. It was quite funny, she had me bend over and she just wiggled it around and viola. Flipped, but deflated. She inflated me and informs me that most likely my expander has a leak, oh yippee for me. Righty was supposed to be the good boob according to Dr Wei’s assistant. Because my final reconstruction is a whole year out I will have to exchange my leaky expander for a new one, but I am going to wait till after I’m done with radiation. 

So Happy National Cancer Survivor Day to me. I am a survivor, and a fighter and I will continue to kick cancer’s ass starting this coming Wednesday June 5thwith radiation therapy